NPIMap

Organization Active NPI

Project Vida Health Center

  • Federally Qualified Health Center (FQHC)
  • El Paso, TX
National Provider Identifier
1396697934
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PROJECT VIDA HEALTH CENTER
Practice address
3612 Pera Ave
El Paso, TX 79905-2412
Phone
(915) 465-1191
Fax
(905) 533-7158
NPI assigned
Feb 13, 2026
Last updated
Feb 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Timothy Davenport-Herbst
Title
Ceo
Phone
(915) 465-1191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

3612 Pera Ave
El Paso, TX 79905-2412

Mailing address

3607 Rivera Ave
El Paso, TX 79905-2415

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260602000048 TX MDPP Supplier - in-Person MDPP Supplier With Distance Learning 4486614765 Practice locations: El Paso, TX

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Project Vida Health Center Inc37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Montana Vista Health CenterEl Paso, TX, CCN 671927 Federally qualified health center Other Jan 1, 2022
Mountain View High SchoolEl Paso, TX, CCN 971003 Federally qualified health center Other Jan 1, 2022

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1770940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770940800000",
    "number": "1396697934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3607 RIVERA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3612 PERA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052412",
            "telephone_number": "915-465-1191",
            "fax_number": "905-533-7158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROJECT VIDA HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-13",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT-HERBST",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "915-465-1191"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.